title: Association of CD8 T cells with depression and anxiety in patients with liver cirrhosis.
abstract: OBJECTIVE
  Depression and anxiety frequently co-occur in patients with. cirrhosis, but their underlying biological substrates are unclear. There is now evidence to suggest that depression is accompanied by signs of an immune response. This study investigated the correlation between depression/anxiety and T-lymphocyte subsets in liver cirrhosis patients.
  
  
  METHODS
  A total of 59 patients (37 males and 22 females; aged between 26-81 years) with cirrhosis were enrolled in the study. Severity of depression and anxiety were assessed through the Hamilton depressive scale (HAMD, the 24-item version) and the Hamilton anxiety scale (HAMA). T-lymphocyte subsets (CD3, CD4, and CD8) in peripheral blood were determined by flow cytometry. The relationship between lymphocyte subsets and depression/anxiety scores was studied by correlation analysis.
  
  
  RESULTS
  The mean total HAMD and HAMA scores for the 59 subjects were 12.8 +/- 10.4 (range = 0-46) and 7.0 +/- 5.7 (range = 0-26), respectively. Fourteen of 59 subjects (23.7%) had HAMD scores equal to or above 20, indicative of depression. The percentage of CD8, but not CD3 or CD4, in T-lymphocyte subsets was positively correlated with depression (HAMD) (r = 0.268, P = 0.043) and anxiety severity (HAMA) (r = 0.321, P = 0.013). After controlling for age and Child-Pugh scores, the correlations were still significant.
  
  
  CONCLUSIONS
  Around one-fourth of cirrhosis patients may have depression, although depression is not related to cirrhosis severity. Our findings are the first to show that depression and anxiety may be associated with increased levels of CD8 in T-lymphocyte subsets in cirrhosis patients, suggesting that an imbalance of T-lymphocyte subsets may be a factor facilitating depression and anxiety in cirrhotic patients. Examination of CD8 T-lymphocytes may prove useful in assessing the potential relationship between depression, anxiety, immunity, and liver cirrhosis.
authors.affiliation: Shuguang Hospital and Institute of Liver Diseases/Shanghai University of Traditional Chinese Medicine, China.
authors.forename: Fang-Yuan
authors.initials: FY
authors.lastname: Ko
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Tsai
authors.forename: Albert C
authors.initials: AC
authors.lastname: Yang
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhou
authors.forename: Lie-Ming
authors.initials: LM
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000209:etiology / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016176:T-Lymphocyte Subsets / Q000276:immunology / Q000473:pathology*